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Joint Bone Spine
Volume 83, n° 2
pages 127-133 (mars 2016)
Doi : 10.1016/j.jbspin.2015.04.010
accepted : 19 April 2015
Cachexia and adiposity in rheumatoid arthritis. Relevance for disease management and clinical outcomes
 

Salima Challal a, Emeline Minichiello a, Marie-Christophe Boissier a, b, Luca Semerano a, b,
a Service de rhumatologie, hôpital Jean-Verdier–René-Muret, groupe hospitalier Avicenne, Assistance publique–Hôpitaux de Paris (AP–HP), 125, rue de Stalingrad, 93000 Bobigny, France 
b Inserm UMR 1125, Sorbonne Paris Cité-université Paris 13, 74, rue Marcel-Cachin, 93000 Bobigny, France 

Corresponding author at: Inserm UMR 1125, Sorbonne Paris Cité-Université Paris 13, 74, rue Marcel-Cachin, 93000 Bobigny, France.
Abstract

Altered body composition is a frequent finding in rheumatoid arthritis and is associated with the two major outcomes of the disease: disability and cardiovascular mortality. It is estimated that up to two thirds of patients may be affected by loss of lean mass, the so-called rheumatoid cachexia. Hence, body weight being equal, the relative amount of lean mass is lower and that of body fat is higher in rheumatoid arthritis patients vs. healthy controls. Both disease-related factors and other factors, like drug treatments, physical activity and nutrition contribute to modify body composition in rheumatoid arthritis. The effect of pharmacological treatments, and notably of anti-TNF drugs, on body composition is controversial. Conversely, training programs to stimulate muscle growth can restore lean mass and reduce adiposity. There is good evidence that amelioration of body composition ameliorates function and reduces disability. Currently, there is no evidence that interventions that modify body composition can reduce cardiovascular morbidity and mortality in rheumatoid arthritis.

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Keywords : Rheumatoid arthritis, Cachexia, Body composition, Disability, Frailty, Cardiovascular disease




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